« The Dual Agenda: April 15, 2015 Issue

State Highlights


The California Department of Health Care Services (DHCS) released a Duals Plan Letter to clarify primary care provider assignments and continuity of care requirements for plans with delegated provider entities in the Cal MediConnect program. The letter outlines several scenarios affecting continuity of care:

In other news, DHCS officials met with the leadership of Health Care Options (HCO) to respond to recent stakeholder concerns and share feedback improve the beneficiary experience. HCO is the branch of DHCS that provides beneficiaries with resources to make informed choices about Medi-Cal benefits, including providing outreach and education about Social Service and Community-Based Organization locations. DHCS has worked with HCO managers to implement a more rigorous training process for new customer service representatives. Daily and weekly reports are shared with DHCS and HCO leadership to ensure customer issues are effectively monitored and addressed promptly.


On April 1, The Disability Advocates Advancing our Healthcare Rights (DAAHR) coalition hosted a meeting on Accountable Care Organizations (ACOs) within MassHealth, the state’s Medicaid program. The meeting was attended by Executive Office of Health and Human Services (EOHHS) Assistant Secretary for MassHealth, Daniel Tsai,tt and a roomful of consumers and advocates. Key takeaways from the meeting were:

New York

The New York Department of Health recently posted two Frequently Asked Questions web pages, one related to the transition of nursing home populations and the other on the Conflict-Free Evaluation and Enrollment Center (CFEEC). The CFEEC was created  to be the single entity responsible for conducting independent enrollee evaluations to assist in the care planning process for the Fully Integrated Duals Advantage (FIDA) program, those seeking Community Based Long-Term Care (CBLTC), as well as for those in the Managed Long-Term Care (MLTC) program. The timeline for implementation of the CFEEC is outlined here.


The Ohio Consumer Voice for Integrated Care (OCVIC) coalition, led by UHCAN Ohio, has launched a newsletter for geriatric providers advocating better care for MyCare Ohio patients. The newsletter is intended to include news, information and advocacy opportunities to assist provider efforts to improve care for patients who are enrolled in MyCare Ohio.

Ohio is one of five states working to leverage the expertise of providers from within the geriatrics and gerontology fields into the work of the Voices for Better Health project.

Rhode Island

The Rhode Island Voices for Better Health partners are playing a key role in the Reinventing Medicaid Working Group announced by Governor Gina Raimondo in late February, including presenting testimony at public meetings. The goals of the workgroup are to: (1) improve quality, affordability, and efficiency (2) eliminate waste, fraud and abuse (3) and make Rhode Island a leader in innovation.

In other news, the Long Term Care Coordinating Council  presented enrollment updates on the Integrated Care Initiative (ICI) at its meeting on April 8. As of April 1, 21,333 individuals were enrolled in the ICI. Of those, 17,470 are enrolled in Rhody Health Options and 3,863 in Connect Care Choice Community Partners. Rhode Island is pursuing its ICI in two waves. The first focuses on managing Medicaid long-term services and supports (LTSS) and improving the coordination of primary care, behavioral health services and home and community-based services. Phase One services are available for dually eligible beneficiaries, as well as Medicaid beneficiaries receiving LTSS. The second phase will be focused on moving to full integration of Medicaid and Medicare services for dually eligible beneficiaries pursuant to an approved demonstration project with the Centers for Medicare and Medicaid Services.


The Virginia Department of Medical Assistance Services (DMAS) recently shared key stakeholder updates:


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